resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A Conversation With Dr. Betty Edmond
This month's column is an exclusive interview with Betty Edmond MD, newly elected CEO/President of the AOMA Graduate School of Integrative Medicine in Austin, Texas.
Qigong for Substance Abuse
It is commonly believed that substance abuse, in addition to harming one’s physiological state, hurts the spirit. There is also a belief that one’s spirit does not weaken due to substance abuse, but rather, the person finds solace in addiction due to an already weak spirit.
Low Back Pain in Running Athletes
After 7 million years of adapting to upright postures, the lumbar spine and pelvis have become remarkably adept at managing ground-reactive forces associated with running.
We Get Letters & Email
Our Country Needs Us Between Elections, Too; Continuing Care: We Aren't There Yet; Our Associations Need to Do More.
An Opportunity & a Responsibility
Nearly 80 Americans die from an opioid-related overdose every day, and spine-related pain is one of the principle drivers of opioid use. This unfortunate situation creates both an opportunity and a responsibility.
True Practice Mobility for the Chiropractic Profession
When natural disasters occur, chiropractors can literally travel to the other side of the world to offer humanitarian relief in less than a day. The chiropractor's license to legally practice, however, can't make it past the state line.
News in Brief
Updated Neck Pain & Whiplash Guideline; Attention, IHS DCs; New VP of Institutional Advancement At Palmer; N.J. DC Interns At U.S. Olympic Training Center; Chiropractic Society Of R.I. On The Front Lines.
Prepare for the End, From the Beginning: Wealth Building and Retirement with the Tao
Yin and yang flow into and out from one another continually. Beginnings become endings and endings become beginnings again. Wholeness and cycles are the nature of Tao.
Five Branches University Has First Hospital TCM Residency
Established in 1984, Five Branches University (FBU) has campuses in Santa Cruz and San Jose, Calif., which serve the communities of Santa Cruz, the Monterey Bay, and Silicon Valley.
Anti-Aging With Dr. Ping Zhang
Jennifer Waters, TCM practitioner and writer of the Acupuncture Today column, "Talking With the Masters" sat down with Dr. Ping Zhang to discuss aniti-aging with acupuncture.
Shoulder Rehab: Start With the Scapula
The scapula is an incredible display of elegance and movement within the biomechanics of human motion. It's evolved for mobility and stability in the scapulo-thoracic region, giving us the ability to do things that are uniquely human, such as throwing with accuracy.
Scar Reduction With Acupuncture & Microneedling (Part 2)
Protocols & treatment Timing
Flirting With Alternative Therapies
There are about as many adjunct therapies being marketed to acupuncturists as there are acupuncturists. While some may remain purist in their application of traditional Chinese medicine, others choose to explore new horizons of treatment.
The Acupuncture Channel System (Part 1)
The earliest Chinese reference to channels is in the Mawangdui Medical Manuscripts,1 which are dated to the Warring States period of the Zhou Dynasty (475 BC-221 AD). The text presents 11 channels. There are no acupuncture points listed in those channels.
The Case Report: A Valuable Tool
Case reports are a valuable form of descriptive research. The most basic form of practice-based research, a case report is a detailed account of the history, presenting symptoms, assessment, observations, treatment and follow-up of an individual patient, discussed in the context of prior and potential future research.
Another Step Forward for Chiropractic
Chiropractic is now available to 86,000-plus Latter-Day Saints missionaries and you are invited to become a provider. LDS membership in not required; our only concern is that our missionaries get the best quality care available.
Crow Like the Rooster
As we welcome in the Year of the Rooster, we look at some of its major characteristics: confidence and communication, which suits the image we have of the Rooster...strutting in the farmyard, crowing to the others that it's time to wake up.
Let's Clear Up the Collection Confusion
This is an often-misunderstood practice swirling with misinformation. First, a few basics: Insurance is a contract between the patient and the insurance company. The insurance company is simply making a payment for services or care on behalf of the patient.
A New Year and Vision for the ACA
Inadequate pain management coupled with the epidemic of prescription opioid overuse and abuse has taken a severe toll on the lives of millions of people in the United States. Every day, more than 1,000 people are treated in the ER for misusing prescription opioids.
The winter season is upon us and offers unique challenges for the clinician and patient alike. To effectively navigate through the winter season there are two main TCM medicinals, Huang Qi and Gan Jiang, to consider, as well as two important formulas which feature these two TCM treasures.
An Education in Gluten Sensitivity
A relatively new syndrome officially documented as non-celiac gluten sensitivity (NCGS) or gluten sensitivity (GS) was officially recognized and published in the new list of gluten-related disorders in 2012.
Nutrition for Menopause: Front-Line Therapy for All Phases
Of all the changes women experience during their reproductive life, there is no doubt the most dreaded are the three phases of menopause. This is not surprising since all of the symptoms associated with menopause are replete with unpleasantness.
March, 2005, Vol. 05, Issue 03
The Inside-Out Paradigm: Equalizing the Pressure
By Dale G. Alexander, LMT, MA, PhD
Read Dale's previous article, "Healing From the Core: A New Paradigm," Parts 1 & 2, in the Sept. and Oct. 2004 issues of Massage Today at: www.massagetoday.com/archives/2004/09/20.html and www.massagetoday.com/archives/2004/10/04.html.
This article will explore a few of the many elements of anatomy and physiology that are fundamental to the proposed paradigm of working from the "inside-out." My first article, "Healing From the Core: A New Paradigm," postulated three core elements that assist the healing process:
The centerpiece of this paradigm is simply to work with how the body maintains itself physiologically and proprioceptively at the same time. Most biomechanical models infer that the source of constricted vascular circulation is the result of the extrinsic musculature's battle to maintain body posture within and against the field of gravity. This is partially accurate. However, it is postulated that contraction of the visceral suspension is a more primary source of vascular congestion and that much of what throws the proprioceptive balance off in the first place is the result of how the body discharges visceral tension into the intrinsic musculature, which then affects the kinetic chain of the joints, thus placing a demand on the extrinsic musculature to contract in order to protect individual joints and the overall balance of an individual. It is a complex both/and scenario. But with further exploration, it will become clearer.
An overlooked aspect of anatomy in our work as massage therapists is that the human body has three great cavities designed to assist the movement of fluids and support the upright carriage of our human structure based on the pressure differences between them. These are the abdominal-pelvic; the thorax; and the cranium.
According to Dr. Jean-Pierre Barral, the developer of Visceral Manipulation, the pressure of the thoracic cavity in a healthy system is negative in relation to the more positive pressures within abdominal-pelvic and cranial cavities. This negative pressure also acts like a helium balloon to support our posture in the field of gravity.1
This difference in the pressure relationships between the cavities is how the efficiency of the low pressure venous and lymphatic systems is normally maintained in their job of returning their fluids back to the heart and lungs to be re-nourished and recycled. Let us remember that fluid moves from an area of greater concentration to an area of lesser concentration naturally. Thus, as one assists the body to re-establish the negative pressure within the thoracic cavity, it allows for an equalization of pressures between the cavities.
How does one tell if the thoracic pressure has become more positive with a client on your massage table? Simple palpation and soft compression of the thorax will readily indicate to you the degree of positive pressure. The less flexible the thorax, the more positive the pressure and, by inference, the slower the flow of venous and lymph return.
Within the body's three great cavities are four visceral sacs:
Each of these sacs is related to physiological waves of expansion and contraction, which are crucial to normal fluid circulation. Their rhythms support the healing process and maintain normal homeostatic regulation:
All of these rhythms are influenced by the pressure within the cavities and sacs, and by the pressure of the tubes within the sacs and by the pressure within those tubes, which pass between the sacs and cavities. Obviously, this adds emphasis to the tone and length of the esophagus, as it is the connecting tube between the cranial vault, thoracic cavity, and abdominal/pelvic cavity. It offers a release valve to the pressures, which often build up within the alimentary canal in addition to the anus at the lower end.
These rhythms are homeostatically regulated between the two divisions of the Autonomic Nervous System; the parasympathetic outflow of the vagus and pelvic splanchnic nerves and the sympathetic nerves exiting from T1-L2 of the spinal cord. It is the flexibility between these two divisions, which regulates who gets the blood thereby the oxygen and nutrients needed to support the healing process.2
How does this pressure in the tubes, sacs and cavities build in the first place? By soft-tissue contraction of the sacs and tubes of the viscera, which lessens the space for the liquids and gases within them. This internal contraction pressurizes the contents. When this pressure is unable to equalize, it builds. The building of pressure creates more soft-tissue tension. The cycle repeats again and again. The body attempts to distribute these tensions both directly and reflexively.
The theorized direct method was described in the first article: visceral tensions build, then spill over into the intrinsic musculature, which then pull on the osseous system until a dysfunction of motion is created affecting joint range of motion. This both releases some of the internal pressure, but also stimulates the extrinsic musculature to contract to protect the joints from further displacement. Inevitably, one's posture and sense of balance is also affected.
The reflexive method involves the distribution of tensions and strain through more generalized viscero-somatic reflex arcs. These relate to both segmental levels of the spinal cord and regional areas that have come to be recognized by surgeons as indicators of acute organ pathology.
What I've come to realize is that the body is organized to use the joints of the axial and appendicular skeleton in a very similar fashion to an electrical circuit-breaker system in a more modern home. Organ correlation to segmental levels of the spinal cord are referred to as spinal correspondences and are maps to the work of chiropractors and the osteopaths who directly manipulate the joints.
Regional reflex areas, such as the right shoulder/scapula area associated with liver/gall bladder congestion, stasis and disease, are referenced in some medical textbooks but are more commonly found, and their relevance more usefully described, in surgical references.3
The paradigm of working from the "inside-out" suggests that as massage therapists, we need to learn how to equalize the pressures within the tubes, sacs, and cavities of the body as a first step to assisting our clients. Additionally, knowledge of the aforementioned spinal correspondences and regional reflex areas can be invaluable for making timely and appropriate referral of our clients to medical care from the onset of working with them, or when they are not making progress.
Competent massage therapy of any orientation will assist stress-induced states of congestion to dissipate with a lessening or disappearance of the initial symptoms. When this doesn't occur, it is our ethical responsibility to encourage medical evaluation. A "well-baby" visit to a physician can be invaluable to the mental health of a client who fears something is amiss.
Stress-related problems follow the progression offered in the first article: adaptation, compensation/substitution, injury/illness, degeneration/disease. Trauma simply speeds one along the continuum. It is common for a client to have all the relevant medical tests and return for additional work as what is brewing within them has not reached the tipping point of recognizable pathology.
Now to lightly kiss the question of why stress affects some people more than others and some in particular areas, while others in totally different ways. As humans, we assign meaning to our experiences in life. We develop a complex array of positive and negative anticipations to events. We live in the models of our mind more than in the present time, experience of life unfolding moment by moment. This is the arena of consciousness and is the most powerful tool for change and evolution for ourselves and our species.
My experience professionally and personally reflects an additional existential theorem, as well: Our bodies are our vehicles for the development of consciousness, the growth of our soul and spirit, and the integration of our personality and spirit. Our bodies are where the action is happening. It embodies our confusions and terrors, our willingness and readiness for change. The body really does reflect a Map of Consciousness.4
Touch bridges time and space, and is the vehicle for re-modeling our inner landscape of attitudes, possibilities and behavior.
For those new to the profession, much of this may have been more than a mouthful, or simply tedious reading, yet it is what we are challenged to hold in our work, and there is more. It has taken years of concentrated experience and study across many disciplines to tease apart the foundational elements of anatomy and physiology to make sense of how the gestalt of the body works in relation to its dance with the psyche.
In truth, this paradigm of working from the inside-out is only the springboard for many connections that are to come in future years.
These basics, and others to follow, have consistently shown themselves to be fundamental to working with clients, especially those with chronic problems. Our real challenge is to expand our perception broadly to include additional dimensions and to nurture our quality of touch to assist our clients to integrate themselves across the many levels of human consciousness.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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